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Oral healthcare management practices in Brazil
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Keywords

Public health
Dentistry
Policy making
Health policy
Practice management

How to Cite

1.
Uchida TH, Suga USG, Garcia Rodrigues C, Umeda JE, Keboa MT, Terada RSS, et al. Oral healthcare management practices in Brazil: systematic review and metasummary. Braz. J. Oral Sci. [Internet]. 2022 Mar. 23 [cited 2024 May 22];21(00):e226252. Available from: https://periodicos.sbu.unicamp.br/ojs/index.php/bjos/article/view/8666252

Abstract

Universal health coverage is a global target included in the United Nations Sustainable Development Goals agenda for 2030. Healthcare in Brazil has universal coverage through the Unified Health System (SUS), which guarantees health as basic right to the Brazilian population. Considering the principles of SUS, public oral healthcare management is a huge challenge. Aim: To identify good management practices for quality care adopted by local public oral healthcare managers and teams around Brazil. Methods: This study was registered with PROSPERO (CRD42017051639). Five databases (PubMed, Embase, Web of Science, Scopus and Lilacs) as well as the reference lists and citations of the included publications were searched according to PRISMA guidelines. Results: A total of 30,895 references were initially found, which were evaluated according to the defined eligibility criteria. Twenty qualitative studies, eight surveys and two mixed-model studies were selected. The practices (codes) were organized into three main groups (families), and the Frequency of the Effect Size (FES) of each code was calculated. Among the 20 codes identified, the most relevant ones were: Diagnosis and Health Planning (FES=80%) and Family Health Strategy (FES=66,7). The Intensity of the Effect Size of each study was also calculated to demonstrate the individual contribution of each study to the conclusions. Conclusion: The evidence emerging from this review showed that healthcare diagnosis, planning, and performance based on the family health strategy principles were the most relevant practices adopted by public oral healthcare managers in Brazil. The widespread adoption of these practices could lead to improved oral healthcare provision and management in Brazil.

https://doi.org/10.20396/bjos.v21i00.8666252
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References

United Nations. The Sustainable Development Goals Report. New York: United Nations; 2017. Available from: https://unstats.un.org/sdgs/files/report/2017/thesustainabledevelopmentgoalsreport2017.pdf.

Dias CMM, Rosa LP, Gomez JMA, D’Avignon A. Achieving the Sustainable Development Goal 06 in Brazil: the universal access to sanitation as a possible mission. An Acad Bras Cienc. 2018;90(2):1337-67. doi: 10.1590/0001-3765201820170590.

Bastos ML, Menzies D, Hone T, Dehghani K, Trajman A. The impact of the Brazilian family health strategy on selected primary care sensitive conditions: A systematic review. PLoS One. 2017 Aug;12(8):e0182336. doi: 10.1371/journal.pone.0182336. Erratum in: PLoS One. 2017 Dec;12 (12):e0189557.

Pucca Junior GA, Gabriel M, Araujo ME, de Almeida FCS. Ten Years of a National Oral Health Policy in Brazil: Innovation, Boldness, and Numerous Challenges. J Dent Res. 2015;94(10):1333-7. doi: 10.1177/0022034515599979.

Mattos GCM, Ferreira EFE, Leite ICG, Greco RM. The inclusion of the oral health team in the Brazilian Family Health Strategy: barriers, advances and challenges. Cien Saude Colet. 2014;19(2):373-82. Portuguese. doi: 10.1590/1413-81232014192.21652012

Pucca Junior GA, Lucena EHG, Cawahisa PT. Financing national policy on oral health in Brazil in the context of the Unified Health System. Braz Oral Res. 2010;24 Suppl 1:26-32. doi: 10.1590/s1806-83242010000500005.

Santos L. The first 30 years of the SUS: an uncomfortable balance? Cien Saude Colet. 2018 Jun;23(6):2043-50. doi: 10.1590/1413-81232018236.06082018.

Gomez CM, Vasconcellos LCF, Machado JMH. A brief history of worker’s health in Brazil’s Unified Health System: progress and challenges. Cien Saude Colet. 2018 Jun;23(6):1963-70. Portuguese, English. doi: 10.1590/1413-81232018236.04922018.

Ravioli AF, Soárez PC, Scheffer MC. Health services management modalities in the Brazilian Unified National Health System: a narrative review of research production in Public Health (2005-2016). Cad Saude Publica. 2018;34(4):e00114217.

Moher D, Liberati A, Tetzlaff J, Altman DG; PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med. 2009 Aug 18;151(4):264-9, W64. doi: 10.7326/0003-4819-151-4-200908180-00135.

Suga US, Terada RS, Ubaldini AL, Fujimaki M, Pascotto RC, Batilana AP, et al. Factors that drive dentists towards or away from dental caries preventive measures: systematic review and metasummary. PLoS One. 2014 Oct;9(10):e107831. doi: 10.1371/journal.pone.0107831.

Hannes K. Critical appraisal of qualitative research [Internet]. In: Noyes J, Booth A, Hannes K, Harden A, Harris J, Lewin S, editors. Supplementary Guidance for Inclusion of Qualitative Research in Cochrane Systematic Reviews of Interventions. Cochrane Collaboration Qualitative Methods Group; 2011 [cited 2021 Jun 4]. Chapter 4. Available from: http://cqrmg.cochrane.org/supplemental-handbook-guidance

CASP - Critical Appraisal Skills Programme. 10 Questions to make sense of qualitative research. 2006 [cited 2021 Jun 4]. Available from: https://casp-uk.net/wp-content/uploads/2018/01/CASP-Qualitative-Checklist-2018.pdf.

Bennett C, Khangura S, Brehaut JC, Graham ID, Moher D, Potter BK, et al. Reporting guidelines for survey research: an analysis of published guidance and reporting practices. PLoS Med. 2010 Aug;8(8):e1001069. doi: 10.1371/journal.pmed.1001069.

O'Cathain A, Murphy E, Nicholl J. The quality of mixed methods studies in health services research. J Health Serv Res Policy. 2008 Apr;13(2):92-8. doi: 10.1258/jhsrp.2007.007074.

Sandelowski M, Barroso J, Voils CI. Using qualitative metasummary to synthesize qualitative and quantitative descriptive findings. Res Nurs Health. 2007 Feb;30(1):99-111. doi: 10.1002/nur.20176.

Sandelowski M, Barroso J. Creating metasummaries of qualitative findings. Nurs Res. 2003;52(4):226-33. doi: 10.1097/00006199-200307000-00004.

Aguilera SLVU, França BHS, Moysés ST, Moysés SJ. Articulation between levels of healthcare services in the Curitiba Metropolitan Area: challenges for managers. Rev Adm Pública. 2013;47(4):1021-40. Portuguese. doi: 10.1590/S0034-76122013000400010.

Aquilante AG, Aciole GG. Oral health care after the National Policy on Oral Health - “Smiling Brazil”: a case study. Cien Saude Colet. 2015;20(1):239-48. doi: 10.1590/1413-81232014201.21192013.

Araújo YP, Dimenstein M. Structure and organization of the work of dentists in the Family Health Program of some Municipal Districts of Rio Grande do Norte (Brazil). Cien Saude Colet. 2006;11(1):219-27. doi: 10.1590/S1413-81232006000100031.

Cavalcanti YW, Lira-Júnior R, Delmondes LN, Prado RL, Padilha WWN. Oral health planning in João Pessoa municipality, Paraíba State: dental surgeons as protagonists of basic care. Acta Sci Health Sci. 2012;34(2):221-5. doi: 10.4025/actascihealthsci.v34i2.10576.

Chaves SC, da Silva LM. Professional practices in public dental healthcare: case study of two municipal districts, Bahia State, Brazil. Cien Saude Colet. 2007;12(6):1697-710. Portuguese. doi: 10.1590/s1413-81232007000600031.

Correa RP, Parente RCP, Moysés NMN. Analysis of oral health actions in the Family Health Strategy of an amazonian riverine municipality. Health Social Change. 2010;1(1):75-80. Portuguese.

Fernandes EGS, Masiero AV, Kuhnen M. Perception of dentists inserted in the Family Health Strategy on multiprofessional work. Rev Gepesvida. 2015;1(2):56-70. Portuguese.

Lippert AO, Mendonça FF, Carvalho BG, Caldarelli PG. The dental specialties center as a point of attention in the oral health care network in a region of Paraná. Braz J Oral Sci. 2020;19:e209984. doi: 10.20396/bjos.v19i0.8659984.

Mello ALSF, de Andrade SR, Moysés SJ, Erdmann AL. Oral health care in the health network and the regionalization process. Cien Saude Colet. 2014;19(1):205-14. doi: 10.1590/1413-81232014191.1748.

Moimaz SAS, Garbin CAS, Garbin AJI, Ferreira NF, Gonçalves PE. Challenges and difficulties of financing oral health: a qualitative analysis. Rev Adm Publica. 2008;42(6):1121-35. Portuguese. doi: 10.1590/S0034-76122008000600005.

Nascimento AC, Moysés ST, Bisinelli JC, Moysés SJ. Oral health in the family health strategy: A change of practices or semantics diversionism. Rev Saude Publica. 2009 Jun;43(3):455-62. doi: 10.1590/s0034-89102009000300009.

Padilha WWN, Valença AMG, Cavalcanti AL, Almeida RVD, Taveira GS. Dental Planning in the Family Health Program of the State of Paraíba: a qualitative study. Rev Pesq Bras Odontoped Clin Integr. 2005;5(1):65-74. Portuguese.

Pimentel FC, Moura R, Acioli L. Análise da atenção à saúde bucal na Estratégia de Saúde da Família do Distrito Sanitário VI, Recife (PE). Ciência e Saúde Coletiva. 2010;15:2189–96. doi: https://doi.org/10.1590/S1413-81232010000400033

Rodrigues AAAO, Assis MMA, Nascimento MAA, Fonseca GS, Siqueira D. Oral Health in the Family Health Strategy in a municipality in the semi-arid region of Bahia. Rev Baiana Saude Publica. 2011;35(3):695-709. Portuguese. doi: 10.22278/2318-2660.2011.v35.n3.a326.

Rossi TRA, Chaves SCL. Secondary dental care implementation in two municipalities in the state of Bahia/Brazil. Saude Debate. 2015;39(spe):196-206. Portuguese. doi: 10.5935/0103-1104.2015S005186.

Sá CR, Kuhnen M, Santos IF, Arruda MP, Toassi RFC. Oral health planning in Primary health care: from theory to practice. Rev APS. 2015;18(1):92-101. Portuguese.

Santos AM, Assis MMA, Rodrigues AAAO, Nascimento MAA, Jorge M. Conflicting situations in the reception of oral health teams from the Family Health Program in Alagoinhas, Bahia, Brazil. Cad Saude Publica. 2007;23(1):75-85. Portuguese. doi: 10.1590/S0102-311X2007000100009.

Santos AM dos, Assis MMA. From fragmentation to integrality: constructing and reconstructing the practice of buccal health in the Alagoinhas (BA) Family Health Program. Cien Saude Colet. 2006;11(1):53-61. Portuguese. doi: 10.1590/S1413-81232006000100012.

Silva Junior CL, Almeida PF, Martins Filho MT, Lima LD. Implementation of Dental Specialty Centers in the context of health regionalization in the state of Ceará, Brazil. Physis. 2020;30(4):1-22. Portuguese. doi: 10.1590/S0103-73312020300404.

Vieira V, de Andrade FR, Castro CGJ, Bighetti TI, Narvai PC. Municipalization of health services according to oral health professionals in an upstate São Paulo municipality in Brazil. Saude Soc. 2013;22(3):795-803. Portuguese. doi: 10.1590/S0104-12902013000300013.

Baldani MH, Fadel CB, Possamai T, Queiroz MGS. [Inclusion of oral health services in the Family Health Program in the State of Paraná, Brazil]. Cad Saude Publica. 2005 Jul-Aug;21(4):1026-35. Portuguese. doi: 10.1590/s0102-311x2005000400005.

Colussi CF, Calvo MCM. An evaluation model for oral health in primary care. Cad Saude Publica. 2011 Sep;27(9):1731-45. Portuguese. doi: 10.1590/s0102-311x2011000900007.

Godoi H, de Mello ALSF, Caetano JC, Zanardi E. Oral Health Care Network: Limitations and Challenges in a Large Municipality of Santa Catarina, Brazil. Saude Transform Soc. 2013;4(4):69-77. Portuguese.

Godoi H, Mello ALSF de, Caetano JC. An oral health care network organized by large municipalities in Santa Catarina State, Brazil. Cad Saude Publica. 2014 Feb;30(2):318-32. Portuguese. doi: 10.1590/0102-311X00084513.

Lessa CFM, Vettore MV. Primary health care management in oral health in Fortaleza, Ceará, between 1999 and 2006 Saude Soc. 2010;19(3):547-56. Portuguese. doi: 10.1590/S0104-12902010000300007.

Lourenço EC, Silva ACB, Meneghin MC, Pereira AC. The insertion of oral health services in the Family Health Program at Minas Gerais State, Brazil. Cien Saude Colet. 2009 Oct;14 Suppl 1:1367-77. Portuguese. doi: 10.1590/s1413-81232009000800009.

Souza TMS de, Roncalli AG. Oral health in the Brazilian Family Health Program: a health care model evaluation. Cad Saude Publica. 2007 Nov;23(11):2727-39. Portuguese. doi: 10.1590/s0102-311x2007001100020.

Aquilante AG, Aciole GG. Building a “Smiling Brazil”? [a "Smiling Brazil"? Implementation of the Brazilian National Oral Health Policy in a health region in the State of São Paulo. Cad Saude Publica. 2015 Jan;31(1):82-96. Portuguese. doi: 10.1590/0102-311x00193313.

Moretti AC, Teixeira FF, Suss FMB, Lawden JAC, Lima LSM, Bueno RE, et al. Intersectoriality in health promotion actions carried out by the oral health team of Curitiba, Paraná State. Cien Saude Colet. 2010 Jun;15 Suppl 1:1827-34. Portuguese. doi: 10.1590/s1413-81232010000700095.

Peduzzi M, Agreli HF. Teamwork and collaborative practice in Primary Health Care. Interface. 2018;22(Supl.2):1525-34. doi: 10.1590/1807-57622017.0827.

Melo LMLL, Moimaz SAS, Garbin CAS, Garbin AJI, Saliba NA. Oral health assessment from the perspective of the municipal manager. RGO. 2016;64(4):402-10. doi: 10.1590/1981-863720160003000063096.

Assis MMA, Alves JS SA. Human resources policies and the (re)signification of workers' practices in the Unified Health System (SUS): notes for the debate. Rev Baiana Saude Publica. 2008;32(Suppl 1):7-15. Portuguese. doi: 10.22278/2318-2660.2008.v32.n0.a1453. [referência não citada no texto]

Moraes Dos Santos ML, Zafalon EJ, Bomfim RA, Kodjaoglanian VL, Mendonça de Moraes SH, do Nascimento DDG, et al. Impact of distance education on primary health care indicators in central Brazil: An ecological study with time trend analysis. PLoS One. 2019 Mar 26;14(3):e0214485. doi: 10.1371/journal.pone.0214485.

Neves RG, Flores TR, Duro SMS, Nunes BP, Tomasi E. Time trend of Family Health Strategy coverage in Brazil, its Regions and Federative Units, 2006-2016. Epidemiol Serv Saude 2018;27(3):e2017170. doi: 10.5123/s1679-49742018000300008.

Galvão TF, Pereira MG. Rating the quality of evidence of systematic reviews. Epidemiol Serv Saude. 2015;24(1):173-5. Portuguese. doi: 10.5123/S1679-49742015000100019.

Lewin S, Glenton C, Munthe-Kaas H, Carlsen B, Colvins CJ, Gülmezoglu M, et al. Using qualitative evidence in decision making for Health and Social Interventions: an approach to assess confidence in findings from Qualitative Evidence Syntheses (GRADE-CERQual). PLoS Med 12(10): e1001895. doi: 10.1371/journal.pmed.1001895.

Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007 Dec;19(6):349-57. doi: 10.1093/intqhc/mzm042.

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